Myoinositol and D-chiroinositol in combination with folates and manganese as factors of male health: effect on sperm structure and fertility

An important factor of secondary male infertility is deficiency of vitamins and microelements. In the present work, a set of studies on myoinositol (MI), D-chiroinositol (DCI), their synergists (folates, manganese ions) in maintaining gametocyte structure and functioning has been systematized. MI and DCI improve the overall and progressive sperm motility by participating in signaling cascades downstream of reproductive hormone receptors (which normalizes androgen metabolism and helps prevent insulin resistance) and improving mitochondrial function. MI and DCI affect sperm maturation/functioning, motility and oocyte fertilization including those mediating inositol-dependent signaling protein phospholipase C-zeta (PLCz) and by modulating the electric fields of gametocytes. Clinical data on MI and DCI use in male infertility suggest an improved state of the zona pellucida, plasma membrane, cytoplasm and sperm reception. Manganese ions contribute to better gametocyte functioning by acting on testosterone concentration, increasing the activity of antioxidant enzymes and mitochondrial potential. Folates lowering gametotoxic homocysteine levels promote maintaining sperm DNA integrity. It is promising to prescribe MI/DCI in combination with organic manganese salts and folates to patients with idiopathic pathospermia, especially paralleled with carbohydrate metabolism disorders (insulin resistance) and reduced antioxidant protection.

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